SPONTANEOUS HYPERTENSIVE REACTIONS WITH MONOAMINE-OXIDASE INHIBITORS

Despite long-standing concerns over hypertensive reactions, monoamine oxidase inhibitors (MAOIs) have grown in popularity and are now used i n a variety of psychiatric disorders. The risk of hypertensive episode s is less than 1%. This is most likely the result of careful dietary i nstructions and prudent prescribing of concomitant medications. The po ssibility exists of spontaneous or unprovoked hypertensive crises in p atients receiving MAOIs. In this report, we review the literature on s pontaneous hypertensive episodes and present a case report. There has been a total of 11 cases described in six separate reports. We discuss the possible mechanism, risk factors, treatment, and safety of rechal lenging the patients with the MAOI. Further research is needed to clar ify this reaction. For now, it remains a rare but worrisome phenomenon . It should stand as an additional source of concern for clinicians wh o are already well aware of the risk of hypertensive episodes in patie nts receiving MAOIs.